摘要
目的探讨腹腔镜下胆总管探查取石术(LCBDE)并双J管内引流的临床应用效果。方法选取2017年1月—2019年9月间收治的胆总管结石患者80例。采用随机数字法分为对照组和观察组,各40例。所有患者均采用LCBDE治疗,对照组采用胆总管内留置T管引流,观察组采用双J管内引流。比较两组手术时间、术中出血量、术后肛门排气时间、住院时间、结石残留率,术后1周谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)变化及术后不良反应。结果观察组手术时间、术中出血量及平均住院天数均少于对照组,术后肛门排气时间早于对照组(P<0.05);两组结石残留率比较(对照组12.50%,观察组2.50%)差异无统计学意义(P>0.05);两组术前及术后1周ALT、AST、TBIL、DBIL组间比较差异无统计学意义(P>0.05);观察组并发症总发生率(5.00%)低于对照组(20.00%),差异有统计学意义(P<0.05)。结论相较于T管引流,LCBDE并双J管内引流一期缝合手术时间短、术中出血量少、术后胃肠功能恢复快、术后住院天数短,并发症少,值得临床应用和推广。
Objective To to investigate the clinical effect of laparoscopic common bile duct exploration and lithotomy(LCBDE)combined with double-J tube drainage.Methods 80 patients with choledocholithiasis admitted to the First Affiliated Hospital of Gannan Medical College from January 2017 to September 2019 were selected.They were randomly divided into control group and observation group,40 cases in each group.All patients were treated with LCBDE.The control group was treated with T-tube drainage in the common bile duct,and the observation group was treated with double-J tube drainage.The operation time,intraoperative blood loss,postoperative anal exhaust time,hospitalization time,stone residual rate,changes of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL)and postoperative adverse reactions were compared between the two groups.Results The operation time,intraoperative blood loss and average length of stay in the observation group were less than those in the control group,and the anal exhaust time was earlier than that in the control group(P<0.05);there was no significant difference in the residual stone rate between the two groups(12.50%)in the control group and 2.50%in the observation group(P>0.05);there was no significant difference in alt,AST,TBIL and DBIL between the two groups before and 1 week after operation(P>0.05);The total incidence of complications in the observation group(5.00%)was lower than that in the control group(20.00%),and the difference was statistically significant(P<0.05).Conclusion Compared with T-tube drainage,LCBDE combined with double-J tube internal drainage has shorter operation time,less intraoperative blood loss,faster postoperative gastrointestinal function recovery,shorter postoperative hospital stay and fewer complications,which is worthy of clinical application and promotion.
作者
李赞滨
张坚红
谢雨林
谢元康
周若霞
何晓
应勇
LI Zanbin;ZHANG Jianhong;XIE Yulin;XIE Yuankang;ZHOU Ruoxia;HE Xiao;YING Yong(The First Affiliated Hospital of Gannan Medical College,Ganzhou 341000,China;不详)
出处
《现代医院》
2021年第3期484-486,489,共4页
Modern Hospitals
基金
江西省卫生计生委科技计划项目(20195408)。
